Perceptions of Actors on the Community-Based Maternal and Neonatal Health Services Project at the Kolda and Sedhiou Regions

Abstract

Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy); 266 groups of pregnant women (Pregnant Women’s Solidarity Circles); 248 Care Group; 468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.